Progressive Goal Attainment Program (PGAP)

PGAP can best be described as a life-role re-integration program. It is an Evidence-Based Treatment Program for Reducing Disability Associated with Pain associated with Musculoskeletal Conditions, Depression, Cancer and other Chronic Health Conditions. It is administered by a trained Occupational or Physio therapist. Within PGAP, disability is viewed as a condition that prevents individuals from participating in many of the life-roles activities that characterised their day-to-day life prior to illness or injury. Disability is also viewed as a state of demoralization and not simply a state of inability.

The primary goals of PGAP are to reduce psychosocial barriers to rehabilitation progress, promote re-integration into life-role activities by identifying those that have been disrupted by injury or illness, increase quality of life and facilitate return to work. These goals are achieved through:

  • Targeted treatment of psychosocial risk factors
  • Structured activity scheduling
  • Graded activity involvement
  • Goal setting & problem solving
  • Motivational enhancement

PGAP is the first disability prevention programme designed to target psychosocial barriers and is based on emerging research supporting the relevance of these barriers on return-to-work outcomes and their amenability to change through intervention. It was designed to complement existing clinical services.
Early intervention is key. PGAP has shown to be most effective with early referral. Once symptom management interventions have been attempted, the focus of treatment should shift from symptoms to disability. This shift needs to occur as early as possible since time will transform the clinical problem into a lifestyle problem. The program consists of the following stages:

  1. An initial screening is arranged to determine the client's suitability for the program.
  2. A PGAP Client Workbook is issued upon entering the program. Weekly sessions of approximately one hour each are scheduled for a maximum of 10 weeks. A mid-program evaluation assists in monitoring the client's progress.
  3. In the final stages of the program, the intervention focuses on activities that will facilitate re-integration into the workplace. The program can be terminated prior to the 10 weeks if the client is ready to return to work.
PGAPTM can be a cost-effective means of improving function and facilitating return to work in individuals at risk for prolonged disability
Journal of Occupational Rehabilitation, 2007

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